COVID-19 Isolation Support Application Form

The COVID-19 Isolation Support benefit is now in place to compensate physicians who have isolated and missed clinical working days due to COVID-19 symptoms, diagnosis or a work-related exposure.

Please complete the following application form and submit your claim. You should submit an application:

  • When your isolation is complete, or when you’ve reached the maximum of 10 missed working days of coverage per isolation occurrence
  • For each occurrence of isolation separately (one application form per isolation)

If you have any questions about your eligibility or about the application process, please contact Barry Hallman at (204) 985-5865 or